| HCPCS Code: |
P9058 |
| Long Description: |
Red blood cells, leukocytes reduced, cmv-negative, irradiated, each unit |
| Short Description: |
Rbc, l/r, cmv-neg, irrad |
| Pricing Indicator 1: |
52 (Reasonable charge) |
| Multiple Pricing Code: |
A (Not applicable as HCPCS priced under one methodology) |
| Statute Number: |
1833T |
| Coverage Code: |
D (Special coverage instructions apply) |
| ASC Payment Group Code: |
|
| Processing Note Number: |
|
| Berenson-Eggers Type of Service (BETOS) Code: |
T1H (Lab tests - other (non-Medicare fee schedule)) |
| Type of Service Code 1: |
0 (Whole blood only effective 01/96, whole blood or packed red cells before 01/96) |
| Anesthesia Base Unit Quality: |
0 |
| Code Added: |
01-01-2004 |
| Action Effective Date: |
01-01-2004 |
| Action Code: |
N (No maintenance for this code) |
